This project will study the application of behavioral medicine to the treatment of adolescents, at increased risk for cardiovascular disease due to elevated blood pressure. Compliance to treatment prescription is a major hurdle in the treatment of adolescent hypertension. Using a cognitive social-learning framework, the project seeks to identify the combination of self-management, external environmental, and behavioral variables effective in helping adolescents make specific behavior changes so that their blood pressure can be reduced and maintained at safe levels. Research goals are two: (1) to study methods by which adolescents with elevated blood pressure can be helped to lose weight, reduce salt intake and learn relaxation skills: (2) to study relationships between habit changes and reductions in blood pressure. Adolescents between 10 and 19 years of age with blood pressures consistently at or above the 95th percentile will be enrolled in this study from the Pediatric Blood Pressure Center of the Johns Hopkins University and Hospital. During the first two years, four time-series experiments, each involving eight subjects will be conducted to study the efficacy of specifc variables in promoting behavior change. These studies will permit us to identify in an efficient and sensitive manner those variables of maximum power in promoting and maintaining habit change. During year three a multi-component program will be constructed and tested using the group factorial design. The procedures identified as effective in this problem area might provide a foundation for the development of prevention and treatment programs and other problem areas such as hyperlipidemia, smoking, diabetes, exercise and eating habits.